Summary: Following a federal investigation, a report has been released that details multiple violations that occurred during Joan Rivers’ procedure at Yorkville.
A report was released on Monday following a federal investigation that found the clinic treating Joan Rivers did not notice that her vital signs had deteriorated for at least 15 minutes prior to her going into cardiac arrest, according to The New York Times.
The report said that the blood pressure for Rivers decreased while she was on the operating table on August 28 between 9:12 and 9:26 a.m., but CPR did not begin until at least 9:28 a.m.
To read more about Joan Rivers, click here.
“The physicians in charge of the care of the patient failed to identify deteriorating vital signs and provide timely intervention during the procedure,” the report said. It was issued by investigators from the Centers for Medicare and Medicaid Services, a federal agency.
According to the report, the anesthesiologist at the Yorkville Endoscopy clinic changed the medical record to show that Rivers was given 120 milligrams of Propofol. The anesthesiologist said that the initial entry of 300 milligrams was entered accidentally by double-clicking on button in the automated system.
The report also said that Dr. Lawrence Cohen, the then-medical director of the clinic, took cellphone pictures of Rivers and her ear, nose and throat doctor, Gwen Korovin as Rivers was on the table under anesthesia.
Cohen reportedly told the others in the room that Rivers might want to see the pictures following her procedure.
Rivers died on September 4, unable to recover from the procedure because of brain damage caused by lack of oxygen.
To read more about Melissa Rivers, click here.
On Monday, the lawyers for Rivers’ daughter, Melissa, issued a statement.
Melissa is “outraged by the misconduct and mismanagement now shown to have occurred before, during and after the procedure. Moving forward, Ms. Rivers will direct her efforts towards ensuring that what happened to her mother will not occur again with any other patient,” said lawyers Jeffrey B. Bloom and Ben Rubinowitz.
Cohen no longer practices at the Yorkville clinic, which is cooperating with investigators. The clinic could lose its Medicare and Medicaid funding if it does not fix the deficiencies found in the report by January 7 and fails a surprise inspection.
Dr. Korovin was brought in by Dr. Cohen even though she did not have the credentials to work at the clinic. Korovin was a personal doctor of Rivers, but there were no documents showing Rivers gave consent for Korovin to perform the procedure.
In regards to the photos being taken, the report stated, “There was no documentation of prior consent by Patient No. 1 authorizing her photographs to be obtained by the facility’s staff members during the procedure.”
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More criticism of the failure to promptly render proper medical care. Yet the lethal affliction remains unidentified? Is this not a classic case of Kounis Syndrome? An allergic reaction to the anesthesia drug Propofol that similarly induced cardiovascular collapse in Michael Jackson? An affliction that doctors fail all too often to readily diagnose and treat — resulting in fatalities that prompt administration of ample epinephrine might have treated successfully. Anaphylactic shock generally — Kounis Syndrome in particular when the sudden, severe allergic reaction results in cardiac arrest, or Kounis-like vasospasms mimicking stroke in patients who may have no preexisting cardiovascular impairment.